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Bicycle handlebar injuries - a systematic review of pediatric chest and abdominal injuries
Roxanne Cheung1, Meghna Shukla2, Katherine G Akers3
1Division of Pediatric Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, USA.
Insights
Bicycle handlebars can cause serious internal injuries in children, often presenting with subtle signs. Prompt medical evaluation is crucial for suspected handlebar thoracoabdominal injuries to prevent complications.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Public Health & Safety
Background:
- Handlebar injuries in children can be severe and easily overlooked.
- Subtle signs and a wide range of internal injuries are associated with handlebar trauma.
Purpose of the Study:
- To describe thoracoabdominal injuries caused by bicycle handlebars in children.
- To analyze the outcomes of these injuries in pediatric patients.
Main Methods:
- Systematic review of English-language articles from 1952 to March 2019.
- Databases searched include PubMed, EMBASE, Cochrane Library, CINHAHL Complete, Web of Science, and Scopus.
- Included studies focused on children aged ≤21 years with thoracoabdominal handlebar injuries from human-powered bicycles.
Main Results:
- 138 articles identified, detailing 1072 children and 1255 thoracoabdominal injuries.
- Common symptoms included abdominal pain, guarding, vomiting, fever, and handlebar imprint; the liver was the most frequently injured organ.
- 2.9% of children required transfer to a higher level of care, and two deaths were reported.
Conclusions:
- Bicycle handlebars pose a significant risk for severe thoracoabdominal injuries in children.
- Clinical signs like abdominal pain, vomiting, fever, or a chest/abdominal imprint warrant thorough investigation.
- Further research is needed to improve diagnostic accuracy and management protocols for these injuries.
Objective:
The severity of handlebar injuries can be overlooked due to subtle signs and wide range of associated internal injuries. Our objective was to describe thoracoabdominal injuries due to bicycle handlebars and their outcomes in children.
Methods:
Articles that reported thoracoabdominal injuries were identified from database conception to March 3, 2019 using PubMed, EMBASE, Cochrane Library, CINHAHL Complete, Web of Science and Scopus. A systematic review of studies of thoracoabdominal handlebar injuries in children ≤21 years on human-powered bicycles in English was performed. Information on demographics, clinical features, injuries, interventions and outcomes was noted.
Results:
A total of 138 articles were identified from 1952 to 2019. There were 1072 children (males, 85.1%) and 1255 thoracoabdominal injuries. Mean age was 9.7 ± 3.3 years old. Common clinical features included abdominal pain and guarding, vomiting, fever and a handlebar imprint. The liver was the most frequently injured organ. Surgery was performed in 338 children with a mean age of 10.0 ± 3.3 years. Twenty-seven children (2.5%) were discharged and returned due to worsening symptoms, of whom 23 (85.2%) required surgery. Thirty-one children (2.9%) transferred to a higher level of care due to injury severity. Two deaths were reported.
Conclusion:
Bicycle handlebars can cause significant thoracoabdominal injuries. Presence of abdominal pain, vomiting, fever or a circular imprint on the chest or abdomen should prompt further workup. Future studies on diagnostic modalities and best practices are needed to lower the chance of missed injuries.
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